The word Aconitum comes from the word "akone," meaning "rocky," which is the type of area where the aconite plant grows. Cured aconite preparations have a long history of use in Chinese medicine. Processed aconite was used to treat heart failure and other heart diseases. However, aconite has been repeatedly associated with cardiovascular (heart) adverse events. For this reason, the German Commission E does not recommend its use.

Aconite is well known for its extreme toxicity. The tuberous root is used in traditional medicine, although all parts of the plant are considered to be toxic. Aconite also has a near worldwide historical usage as an arrow poison and as a poison in executions, homicides, and suicides. Aconite is also said to be an ingredient of "flying ointments" used by witches to imitate the sensation of flying.

Aconite has been used in very low doses to treat neuralgia (nerve pain), sciatica, and rheumatism. Aconite is also an ingredient in homeopathic preparations used for cold and flu symptoms, heart palpitations with anxiety, acute inflammatory illness, and peripheral nerve pain. Overall, the efficacy has not been established.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

The toxic effects associated with aconitine (a poisonous alkaloid and the active principle of aconite) limit its ability to be used to treat bradycardia (slow heartbeat). Additional study is needed in this area to make a strong recommendation.

C

The toxic effects associated with aconite limit its ability to be used to treat heart failure, including reno-cardiovascular disease and left ventricular function. Further study is needed to confirm these results.

C

There is limited data on the use of aconite or any of its derivatives in treating pain. Homeopathic aconite may help relieve postoperative agitation, but further information is needed to confirm these results.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

There is no proven safe or effective dose for aconite. Topical (application on the skin) use is not recommended. Aconite is sometimes used in liniments (rubifacients) with belladonna. Historically, a 1.3% aconitine topical liniment has been used.

Taking 1-5 drops of a tincture of the fresh leaf by mouth four times a day to relieve pain has been used. Also, homeopathic preparations of 6c to 30c have been used. A 6c potency strength is made by diluting one part of aconite tincture to 99 parts of alcohol or water then the solution is taken and diluted again with 99 parts of alcohol or water. This process is repeated 6 additional times, resulting in a 6c potency.

Children (younger than 18 years)

There is no proven safe or effective dose for aconite, and use in children is not recommended. Homeopathic aconite has been studied in infants to help relieve postoperative agitation, but further information is needed to confirm these results.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Aconite is highly toxic and is not safe for human consumption.

Side Effects and Warnings

Based on widespread use, many experts believe aconite to be unsafe even in recommended amounts in otherwise healthy individuals. Aconite is not recommended for children because of known toxic effects; however, a homeopathic preparation containing aconite has been studied in infants with no toxicity reported.

Severe poisoning has been reported after ingestion of aconitine (found in aconite) or processed and cured aconite. Aconite is not approved by the German Commission E for use in any patients. The American Herbal Product Association rated aconite a class 3 (to be used only under the supervision of an expert qualified in the appropriate use of this substance).

Tingling and numbness have occurred when aconite is applied to the skin (topically).

Aconite may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.

Aconite is contraindicated in patients with coronary disease, cardiac dysfunction, and arrhythmias or homodynamic instability. Use cautiously in patients with suicidal tendencies due to the abuse potential associated with aconite. Avoid aconite in patients less than 18 years of age due to a lack of research in this patient population. Avoid aconite use in patients with gastrointestinal disorders, stomach ulcers, duodenal ulcers, reflux esophagitis, ulcerative colitis, spastic colitis, and diverticulosis.

Pregnancy and Breastfeeding

The use of aconite during pregnancy or breastfeeding should be avoided since it is known to be toxic even at therapeutic doses. Studies suggest it is unsafe when used orally (taken by mouth) or topically (applied to the skin) in pregnant women.

Anti-arrhythmic medications may antagonize the effects of aconite and increase the risk of cardiotoxicity or other side effects. Patients taking anti-arrhythmics or other heart medication should consult with a qualified healthcare professional, including a pharmacist.

Aconitine may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

Aconitine may lower blood pressure. Caution is advised when using medications that may also lower blood pressure. Also, combined use of aconitine (an alkaloid found in aconite) with anesthetic medications or diuretic medications (those that increase urine flow) may also lower blood pressure. Caution is advised.

Theoretically, digoxin may interfere with aconitine effects on the heart. Combined use of these medications could be extremely dangerous and result in additive effects of both agents. Consult with a qualified healthcare professional, including a pharmacist.

Interactions with Herbs and Dietary Supplements

Aconitine may lower blood pressure. Caution is advised when using herbs or supplements that may also lower blood pressure. Also, combined use of aconitine (an alkaloid found in aconite) with herbs and supplements that have anesthetic effects or diuretic effects (those that increase urine flow) may also lower blood pressure. Caution is advised.

Aconitine may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar.

Theoretically, digoxin-like herbs or supplements (foxglove, Siberian ginseng) may interfere with aconite effects on the heart producing an unknown and potentially dangerous effect. Consult with a qualified healthcare professional, including a pharmacist before combining therapies.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.